Evolve: missed questions for P&R

The charge nurse is preparing for the arrival of clients to the emergency department (ED) after a mass casualty incident (MCI). The hospital has an automatic tracking system that is implemented during MCIs. Which decision should the nurse use the system for during this MCI?

To determine how many casualties of each acuity level can be safety accepted

After a bomb blast in a city, why would the federal government send the Medical Reserve Corps (MRC) to the site?

To establish first aid stations or special-needs shelters

What are the functions of the Hospital Incident Command System (HICS) in disaster management? Select all that apply.

To standardize disaster operations To establish an emergency operations center (EOC)

Which organism would the nurse explain is consistent with a protozoal infection in clients with acquired immunodeficiency syndrome (AIDS)?

Toxoplasmosis

The nurse caring for a 3-year-old child with meningitis should be alert for which signs and symptoms of increased intracranial pressure? Select all that apply.

Vomiting, headache, irritability

Which are sources of lead the nurse should assess for when providing care to a toddler-age client who is admitted with lead poisoning? Select all that apply.

Water, pottery, collectable toys, vinyl miniblinds

A 67-year-old client has tested positive for influenza A. The client also has asthma. Which drug would the nurse recommend be avoided in this client?

Zanamivir

A 2½-year-old toddler is admitted with a fever of 103° F (39.4° C), stiffness of the neck, and general malaise. The diagnosis is acute bacterial meningitis. What is the priority nursing intervention for this child?

instituting droplet precautions

For what clinical manifestations should the nurse assess a client during the first few hours of the alcohol withdrawal? Select all that apply.

irritability, tachycardia, increased anxiety

The nurse is studying the stages that characterize the progression of chemical pneumonia in young children following ingestion of a hydrocarbon. Which symptoms does the nurse correctly list as occurring in the third stage postingestion, between 72 to 96 hours? Select all that apply.

stupor, coagulation abnormalities, pain in upper right quadrant

The nurse is comparing Meso-2,3-dimercaptosuccinic acid (DMSA) and British antilewisite (BAL) as chelating agents to be used as treatment for lead poisoning. Which statements indicate correct knowledge regarding chelating agents? Select all that apply.

"DMSA is given orally while BAL is given intramuscularly." "Both DMSA and BAL are given in repeated doses over several days."

The nurse is providing care to a toddler-age client of Iraqi descent diagnosed with lead toxicity. Which question is most appropriate for the nurse to include in the assessment process to determine the source of the lead?

"Do you use Lozeena when cooking for your child?"

A nurse is teaching a group of healthcare workers about the prevention of human immunodeficiency virus (HIV) transmission by healthcare workers. Which statements made by a healthcare worker indicate the need for the further teaching? Select all that apply.

"I should never re-use equipment used in invasive procedures." "If I am infected with HIV, I am restricted from practice of non-exposure-prone procedures."

A hospitalized client is on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA). Which statement by an unlicensed assistive personnel (UAP) (Canada: continuing care assistant, CCA) indicates a need for further teaching?

"I will remove the gown, then the gloves, before washing my hands." Remove gloves, then gown, then wash hands.

The head nurse of the emergency department is teaching a group of student nurses about Critical Incident Stress Debriefing (CISD) in emergency nursing. Which statement of the student nurse indicates a need for further teaching?

"The coleader is responsible for keeping unauthorized people out."

The nurse would consider which disaster management plan to be most applicable if an earthquake hits a metropolitan area, causing widespread death and injuries? Select all that apply.

-Activation of the facility's emergency management plan -Collaboration of multiple agencies and healthcare facilities

During a disaster response, the emergency department (ED) charge nurse is performing functions according to the healthcare facility emergency preparedness and response plan. Which interventions performed by the ED charge nurse are most appropriate? Select all that apply.

-Assign a communications nurse to work with the media personnel -Assign acritical care unit nurse to transfer the clients out to expand the capacity -Inform the medical command physician about the need for providers with specialty training

What does the registered nurse consider to be the roles and functions of a medical command physician during implementation of an emergency preparedness and response plan? Select all that apply.

-Identifying the need for and calling in specialty trained providers -Determining the clients who require a higher level of care and relocating them

What areas should the nurse keep in mind when participating in the planning of an organization's emergency preparedness plan? Select all that apply.

-Needs for security -Staffing for surge situations -Methods of communication -Definition of specific nursing roles

The head nurse of the emergency department (ED) is assigning duties to volunteer nurses to care for a group of clients injured in a mass casualty situation. Which assignments are appropriate in this situation? Select all that apply.

-The trauma nurse manager should organize ancillary services. -The medical-surgical nurse should recommend clients for discharge. -The ED nurse leader should direct the ancillary departments to deliver supplies.

Arrange in order the events that occur when a nurse provides emergency treatment to a preschooler who is a victim of poisoning.

1. Assess the victim 2. Terminate poison exposure 3. Identify poison 4. Prevent absorption

A group of clients injured during a wildfire are admitted to an emergency unit. Which order should the nurse follow in disaster management?

1. Designing a plan to structure the response and assess risk 2. Attempting to limit a disaster's impact on human health 3. Actual implementing of the disaster plan 4. Focusing actions on stabilizing the community 5. Evaluating the response effort to prepare for the future

A client critically injured in a bomb blast is admitted to an emergency unit. Which order should the nurse follow to perform initial assessment to manage immediate threats in the client?

1. Establishing a patent airway by positioning, suctioning, and oxygen as needed 2. Assessing breathing sounds and respiratory effort 3. Monitor vital signs 4. LOC with GCS 5. removing all clothes for a physical assessment

Victims from an accident at the nuclear power plant are rushed to the hospital. Which staff members will be the first to manage this situation?

1. Prehospital care providers 2. Paramedics 3. Emergency medical technicians 4. Emergency medicine physician

An alcohol-intoxicated client is found near drowning. What is the emergency care provided to the client by the nurse in the order of priority?

1. Safely rescue the client. 2. Stabilize the spine with a board. 3. Perform cardiopulmonary resuscitation. 4. Perform gastric decompression with a nasogastric tube.

When planning a citywide national homeland security disaster preparedness drill, a nurse is assigned to the triage committee. Place the following criteria in an order that reflects the most efficient triage plan for an actual mass casualty incident (MCI).

1. Tension pneumothorax 2. compound fracture 3. laceration of thigh muscle 4. severe wrist sprain 5. crushing head injury

What is the correct order of phases in a disaster management plan?

1. preparedness 2. mitigation 3. response 4. recovery 5. evaluation

A disaster management team is planning a protocol for survivors of a winter storm who present with frostbite. How would the nurse order the interventions in the protocol?

1. remove victim from cold environment 2. immerse feet in warm water 3. give pain medication 4. apply sterile and loose dressings

The nurse administers an initial dose of Haemophilus influenzae type b (Hib) vaccine to a 2-month-old infant. When should the nurse administer the final dose of the vaccine to the infant?

12-15 months

Haemophilus influenzae type b (Hib) vaccine schedule

2 months, 4 months, 6 months, 12-15 months

DTaP vaccine schedule

2 months, 4 months, 6 months, 15-18 months, 4-6 years

When writing a disaster plan for implementation during a mass casualty incident (MCI), which percentage of victims often require admission to the hospital for further treatment?

30%

Protease inhibitors agents

All end in "avir"

What does the nurse identify as an early sign of chronic lead poisoning (plumbism) in school-aged children?

Anemia

A nurse is reviewing the health history and laboratory report of a child with lead poisoning. What complications does the nurse expect in relation to lead toxicity? Select all that apply.

Anemia, proteinuria, encephalopathy

Pentamidine: class

Antiprotozoal / antifungal

Two siblings who live in a camp for migrant workers have contracted measles. The nurse, trying to determine which individuals had contact with the children, identifies those with immunity and assesses the probability of containing the measles to the camp. What technique has the nurse used in managing this situation?

Epidemiological process

A nurse is involved in an international committee to address global health problems. What suggestion is most appropriate for the nurse to make to best meet the challenge associated with a potential emerging influenza pandemic?

Establish a global surveillance plan

What does the nurse explain are the effects of lead poisoning in a preschooler? Select all that apply.

Brain damage, growth retardation

A client with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine. Which laboratory values are most important for the nurse to monitor in this client?

CBC - Pancytopenia

Which parental occupations would require the nurse to closely monitor a toddler-age client for lead toxicity? Select all that apply.

Ceramics work radiator repair bridge repair work brass foundry work

Which entity is responsible for activating the disaster plan during a mass casualty incident (MCI)?

Federal emergency management agency

The federal government established the Medical Reserve Corps (MRC) to collaborate with other disaster management teams to triage clients after a terrorist attack. Which client care would not be handled by the MRC?

Client with head injury

Which health care team member is a first responder when an emergency or mass casualty incident (MCI) occurs?

Critical care nurse

A client with acquired immunodeficiency syndrome (AIDS) is receiving a treatment protocol that includes a protease inhibitor. When assessing the client's response to this drug, which common side effect should the nurse expect?

Diarrhea, nausea, vomiting. Pt teaching: take with a meal or light snack Additional: hyperglycemia,

What would the nurse explain is the action taken by the disaster management team when planning the response to reduce the spread of a smallpox pandemic?

Distribute the vaccine

Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply.

Dyspnea, diaphoresis, high temperature

The nurse manager is designated as a unit Chief during the formulation of a Hospital Incident Command System (HICS) for disaster preparedness. Which responsibility does the nurse manager assume in this role?

Logistics and operation

The disaster management team is evaluating the damage that can happen due to a disaster. They also attempt to limit the influence of the disaster on the health community's function. Which phases of disaster management would the nurse state represents these actions? Select all that apply.

Mitigation Preparedness

Acute lead poisoning

Nausea, vomiting, anorexia, hypophosphatemia

A healthcare provider prescribes aspirin therapy for a client with arthritis and the nurse provides teaching about the undesirable side effects of this medication. What responses should the client identify as reasons to notify the healthcare provider? Select all that apply.

Ongoing nausea Easy bruising Ringing in the ears

A nurse is providing colostomy care to a client with a nosocomial infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Which personal protective equipment (PPE) should the nurse use? Select all that apply.

Gloves, gown, goggles.

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcal pneumonia frequently is incontinent of feces and urine and produces copious sputum. When giving this client a bath, which protective equipment should the nurse make it a priority to use? Select all that apply.

Gloves, gown, surgical mask.

A mother whose child has been killed in a school bus accident tells the nurse that her child was just getting over the chickenpox and did not want to go to school but she insisted that the child go. The mother cries bitterly and says that her child's death is her fault. The nurse understands that perceiving a death as preventable most often will influence the grieving process in that it may do what?

Grow in intensity and duration

Which client would the nurse state shows symptoms of influenza?

Headache, muscle aches, fever, chills, fatigue, weakness, sore throat, cough, watery nasal discharge lasting more than a week, nausea, vomiting, diarrhea.

What type of immunity should the nurse explain was transferred to her baby through the placenta?

Passive natural

The geographic location of a community makes it vulnerable to storms. The community health nurse teaches the community about safety measures to be taken during a storm. Which phase of disaster management is this action?

Preparedness

A local emergency department (ED) recently implemented an automated tracking system for triage during mass casualty incidents (MCIs). Which items can the nurse track using this system? Select all that apply.

Priority upon arrival, interaction with caregivers, priority per process of care, priority according to location

Protease inhibitors and HIV patients: MOA

Protease is an enzyme in the body required for HIV cell replication

A pediatric client with a history of chickenpox is undergoing treatment for mental illness with psychotherapeutic drugs. Which is the expected adverse effect of the psychotherapeutic drug in the pediatric client?

Reye's syndrome

The nurse is administering vaccines following an episode of pandemic influenza. Which entity should the nurse consult as being ultimately responsible for the implementation of the plan?

State officials

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcal pneumonia frequently is incontinent of feces and urine and produces copious sputum. When giving this client a bath, which protective equipment should the nurse make it a priority to use? Select all that apply.

Surgical mask, gown, gloves

The nurse is providing care to a toddler-age client of Indian descent diagnosed with lead toxicity. Which question is most appropriate for the nurse to include in the assessment process to determine the source of the lead?

Surma

Which school-age developmental characteristics increases the client's risk for poisoning? Select all that apply.

Adhering to group rules Being easily influenced by peers Having a strong allegiance to friends

After assessing a 5-year-old child, the nurse suspects the child has mumps. Which symptoms present in the child may support the nurse's suspicion? Select all that apply.

Fever (100-104F), swelling of the parotid gland.

The disaster management team is working to manage the aftermath of an accidental explosion in a fertilizer plant and has started evacuating the injured and uninjured victims from danger as first line of action. Which team member most likely engages in this action?

Firefighter

A nurse works with a large population of immigrant clients and is concerned about the debilitating effects of influenza. Which action by the nurse is the first line of defense against an emerging influenza pandemic?

Reporting surveillance findings to appropriate public health officials